Cargando…

Expression of p53 predicts risk of prevalent and incident advanced neoplasia in patients with Barrett's esophagus and epithelial changes indefinite for dysplasia

Background and aims: Patients with Barrett’s esophagus (BE) are at an increased risk for developing esophageal adenocarcinoma (EAC); thus they may undergo regular endoscopic surveillance. If epithelial changes cannot be unequivocally classified as negative or positive for dysplasia, a diagnosis of i...

Descripción completa

Detalles Bibliográficos
Autores principales: Horvath, Bela, Singh, Prabhdeep, Xie, Hao, Thota, Prashanthi N, Sun, Xingwen, Liu, Xiuli
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5193059/
https://www.ncbi.nlm.nih.gov/pubmed/26486567
http://dx.doi.org/10.1093/gastro/gov045
_version_ 1782487895589781504
author Horvath, Bela
Singh, Prabhdeep
Xie, Hao
Thota, Prashanthi N
Sun, Xingwen
Liu, Xiuli
author_facet Horvath, Bela
Singh, Prabhdeep
Xie, Hao
Thota, Prashanthi N
Sun, Xingwen
Liu, Xiuli
author_sort Horvath, Bela
collection PubMed
description Background and aims: Patients with Barrett’s esophagus (BE) are at an increased risk for developing esophageal adenocarcinoma (EAC); thus they may undergo regular endoscopic surveillance. If epithelial changes cannot be unequivocally classified as negative or positive for dysplasia, a diagnosis of indefinite for dysplasia (IND) is recommended. Several biomarkers have been proposed as markers or predictors of neoplasia in the general BE population; however, their significance is not clear in patients with BE-IND. We therefore performed a retrospective study to determine whether expression of these biomarkers was associated with the development of neoplasia in BE-IND patients. Methods: We searched our archives to identify all cases of BE-IND diagnosed between January 1992 and December 2007. Immunohistochemical analyses were used to semi-quantify the expression of p53, α-methylacyl-CoA racemase (AMACR), and cyclin D1. A univariate analysis was used to identify predictors for prevalent and incident neoplasia and advanced neoplasia. Results: Among the 103 patients with an index diagnosis of BE-IND who were included in this study, 81 (78.6%) underwent a follow-up biopsy within 12 months of diagnosis; 10 (12.3%) had neoplasia, including four (4.9%) with advanced neoplasia. Among 79 patients without prevalent neoplasia who underwent more than 1 year of follow-up, 18 (22.8%) had developed neoplasia, including four (5.1%) with advanced neoplasia. AMACR and cyclin D1 expression levels were not correlated with prevalent or incident neoplasia; however, high p53 expression (>5%) was associated with prevalent advanced neoplasia on surveillance biopsy (P = 0.04) and with an increased risk of progression to advanced neoplasia (HR = 12; P = 0.03). Conclusion: In this study, p53 expression was found to be predictive of prevalent advanced neoplasia and progression to advanced neoplasia in patients with BE-IND.
format Online
Article
Text
id pubmed-5193059
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-51930592017-01-04 Expression of p53 predicts risk of prevalent and incident advanced neoplasia in patients with Barrett's esophagus and epithelial changes indefinite for dysplasia Horvath, Bela Singh, Prabhdeep Xie, Hao Thota, Prashanthi N Sun, Xingwen Liu, Xiuli Gastroenterol Rep (Oxf) Original Articles Background and aims: Patients with Barrett’s esophagus (BE) are at an increased risk for developing esophageal adenocarcinoma (EAC); thus they may undergo regular endoscopic surveillance. If epithelial changes cannot be unequivocally classified as negative or positive for dysplasia, a diagnosis of indefinite for dysplasia (IND) is recommended. Several biomarkers have been proposed as markers or predictors of neoplasia in the general BE population; however, their significance is not clear in patients with BE-IND. We therefore performed a retrospective study to determine whether expression of these biomarkers was associated with the development of neoplasia in BE-IND patients. Methods: We searched our archives to identify all cases of BE-IND diagnosed between January 1992 and December 2007. Immunohistochemical analyses were used to semi-quantify the expression of p53, α-methylacyl-CoA racemase (AMACR), and cyclin D1. A univariate analysis was used to identify predictors for prevalent and incident neoplasia and advanced neoplasia. Results: Among the 103 patients with an index diagnosis of BE-IND who were included in this study, 81 (78.6%) underwent a follow-up biopsy within 12 months of diagnosis; 10 (12.3%) had neoplasia, including four (4.9%) with advanced neoplasia. Among 79 patients without prevalent neoplasia who underwent more than 1 year of follow-up, 18 (22.8%) had developed neoplasia, including four (5.1%) with advanced neoplasia. AMACR and cyclin D1 expression levels were not correlated with prevalent or incident neoplasia; however, high p53 expression (>5%) was associated with prevalent advanced neoplasia on surveillance biopsy (P = 0.04) and with an increased risk of progression to advanced neoplasia (HR = 12; P = 0.03). Conclusion: In this study, p53 expression was found to be predictive of prevalent advanced neoplasia and progression to advanced neoplasia in patients with BE-IND. Oxford University Press 2016-11 2015-10-19 /pmc/articles/PMC5193059/ /pubmed/26486567 http://dx.doi.org/10.1093/gastro/gov045 Text en © The Author(s) 2015. Published by Oxford University Press and the Digestive Science Publishing Co. Limited. http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Horvath, Bela
Singh, Prabhdeep
Xie, Hao
Thota, Prashanthi N
Sun, Xingwen
Liu, Xiuli
Expression of p53 predicts risk of prevalent and incident advanced neoplasia in patients with Barrett's esophagus and epithelial changes indefinite for dysplasia
title Expression of p53 predicts risk of prevalent and incident advanced neoplasia in patients with Barrett's esophagus and epithelial changes indefinite for dysplasia
title_full Expression of p53 predicts risk of prevalent and incident advanced neoplasia in patients with Barrett's esophagus and epithelial changes indefinite for dysplasia
title_fullStr Expression of p53 predicts risk of prevalent and incident advanced neoplasia in patients with Barrett's esophagus and epithelial changes indefinite for dysplasia
title_full_unstemmed Expression of p53 predicts risk of prevalent and incident advanced neoplasia in patients with Barrett's esophagus and epithelial changes indefinite for dysplasia
title_short Expression of p53 predicts risk of prevalent and incident advanced neoplasia in patients with Barrett's esophagus and epithelial changes indefinite for dysplasia
title_sort expression of p53 predicts risk of prevalent and incident advanced neoplasia in patients with barrett's esophagus and epithelial changes indefinite for dysplasia
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5193059/
https://www.ncbi.nlm.nih.gov/pubmed/26486567
http://dx.doi.org/10.1093/gastro/gov045
work_keys_str_mv AT horvathbela expressionofp53predictsriskofprevalentandincidentadvancedneoplasiainpatientswithbarrettsesophagusandepithelialchangesindefinitefordysplasia
AT singhprabhdeep expressionofp53predictsriskofprevalentandincidentadvancedneoplasiainpatientswithbarrettsesophagusandepithelialchangesindefinitefordysplasia
AT xiehao expressionofp53predictsriskofprevalentandincidentadvancedneoplasiainpatientswithbarrettsesophagusandepithelialchangesindefinitefordysplasia
AT thotaprashanthin expressionofp53predictsriskofprevalentandincidentadvancedneoplasiainpatientswithbarrettsesophagusandepithelialchangesindefinitefordysplasia
AT sunxingwen expressionofp53predictsriskofprevalentandincidentadvancedneoplasiainpatientswithbarrettsesophagusandepithelialchangesindefinitefordysplasia
AT liuxiuli expressionofp53predictsriskofprevalentandincidentadvancedneoplasiainpatientswithbarrettsesophagusandepithelialchangesindefinitefordysplasia